Around 15 million people worldwide have Alzheimer’s disease, the most common form of dementia.  Mild cognitive impairment (MCI) is a condition marked by memory and other intellectual problems which may precede Alzheimer’s disease. 

There is increasing interest now in pinpointing those patients who are most likely to progress from MCI to full-blown Alzheimer’s disease.  For, although there is no cure for Alzheimer’s disease as yet, there are various treatments that can be applied – and the earlier the better.  Therefore the early diagnosis of Alzheimer’s disease is a worthwhile clinical goal.

Researchers at the University of Gothenburg, Sweden, carried out a study of patients with MCI to see if biomarkers in the cerebrospinal fluid (CSF) can identify those who are likely to progress to Alzheimer’s disease.  The three biomarkers were related to the beta-amyloid and tau proteins known to be involved in Alzheimer’s through studies of affected brain tissue.  A total of 750 participants with MCI, 529 with Alzheimer’s disease, and 304 controls from 12 centers in Europe and the United States were followed up for two years or till symptoms of dementia appeared, having had their CSF measured for the three biomarkers.

During the follow up period, 271 of the MCI participants developed Alzheimer’s disease and 59 developed other forms of dementia.  Biomarker analysis showed lower levels of the three biomarkers in the CSF of those who went on to develop Alzheimer’s disease than those who did not. The biomarker test is not, it must be stressed, a new diagnostic test for Alzheimer’s disease.  Testing CSF is hardly routine and, in its present form, the biomarker test could throw up both false positive and false negative results. But it may be used, in the future, in memory clinics to identify those patients with MCI who need further investigation.  It also forms the basis for more research into what these particular biomarkers can tell us about the pathogenesis of Alzheimer’s disease. And, as biomarker research becomes ever more sophisticated, this approach will take on an increasingly important role in the diagnosis and management of Alzheimer’s disease. 

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Source

Mattsson N, Zetterberg H et al CSF biomarkers and incipient Alzheimer's disease in patients with mild cognitive impairment Journal of the American Medical Association July 22 2009;302:385-393